This paper identifies, reviews, and examines legislation in English-speaking Caribbean countries and territories applicable to the prevention and control of obesity, diabetes, and cardiovascular diseases and the need to enact further legislation to prevent chronic noncommunicable diseases. It also acknowledges the role played by PAHO and CARICOM in their efforts and commitment to fight these diseases. (Washington, DC, June 2010)
Executive Summary | Full Text (237 pp, PDF)
Part 1: Legislation in Countries and Territories of the English-Speaking Caribbean—Antigua, Anguilla, Bahamas, Barbados, Belize, Dominica, Guyana, Jamaica, Montserrat, St. Lucia, St. Vincent and the Grenadines, Trinidad and Tobago
Part 1 identifies legislation in English-speaking Caribbean countries and territories applicable to the prevention and control of obesity, diabetes and cardiovascular diseases. Instances of such legislation are few. Legislation is the enactment of Government's policy and legislative provisions are for the most part mandatory, attracting sanctions for non-compliance therewith. With respect to the English-speaking Caribbean countries and territories, research through their statute books, bound annual volumes of Laws, and unbound annual collections of recent Laws extracted from periodically issued gazette supplements prior to their preparation and binding into annual volumes, suggests that governments of English-speaking Caribbean countries and territories need to enact comprehensive legislation relating to the prevention and treatment of obesity, diabetes and cardiovascular diseases.
Part 2: Legislation review points to the need for enactment of policies and norms into law; typology for new or revised legislation
Part 2 reviews the legislation researched, points to the need for enactment of policies and norms into law and suggests a typology for new or revised legislation for the prevention and control of obesity, diabetes and cardiovascular diseases.
Part 3: National strategic health plans and the gestation of norms for the prevention and control of noncommunicable diseases
Part 3 examines some National Strategic Health Plans among the priorities of which are the prevention and control of chronic non communicable diseases, including obesity, diabetes and cardiovascular diseases. These plans set principles to guide legislation renewal.
Part 4: The Pan American Health Organization as a positioning compass in the prevention and control of noncommunicable diseases
Part 4 of the Paper acknowledges that the Pan American Health Organization for well over a decade has been the positioning compass in the prevention and control of chronic noncommunicable diseases. As early as 1995 Sr. George Alleyne, former Director of the Pan American Health Organization (PAHO) established the Non-Communicable Disease Program within the division of Disease Prevention and Control with a mandate to strengthen the capacity of the organization in support of specific prevention and control activities in member countries. In 2007, Dr. Mirta Roses Periago, present Director of PAHO at the Regional Summit on Chronic Noncommunicable Diseases, viewed what she termed "three universal actions you have decided upon that will be critical:
- First is to Mobilize for action and establish intersectoral national commissions which have to engage other Government sectors, the private sector and civil society to promote awareness and create public support for the creation of enabling policies and legislation that are comprehensive and multifactorial.
- Second is the improvement of financing NCD prevention and control, and the use of fiscal incentives and disincentives to modify lifestyles and behaviors. Taxes can be increased to discourage consumption and also to make resources available for funding health promotion activities.
- And thirdly, the development of a plan for improving coverage and quality of care for people with chronic diseases, and ensuring that the right components are incorporated in the national and regional insurance schemes.
Part 5: Recognition of norms emanating from declarations of regional conferences—Declaration of Port-of-Spain, and the Declaration of St. Ann's
Part 5 places specific emphasis on the Declaration of Port-or-Spain, and the Declaration of St. Ann, to the extent of reproducing them verbatim. The importance of the contents of each speaks for itself. The Declaration of Port-of-Spain was issued at the conclusion of the CARICOM Heads of Government Summit: Uniting to Stop the Epidemic, held in Port-of-Spain, Trinidad and Tobago, on September 15, 2007, to address the issue of chronic non-communicable diseases. The Declaration called on Member States of CARICOM to establish National Commissions on chronic non communicable diseases and to enact a number of other measures to address the epidemic. Also included in this section is the PAHO Regional Strategy and Plan of Action on an Integrated Approach to the Prevention and Control of Chronic Diseases, Including Diet, Physical Activity, and Health.
Part 6: Suggested readings
Part 6 lists background readings.